EHR Objectives

8/14/2019 EHR Objectives

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Health Outcomes

Policy Priority

Care Goals Objectives for

Eligible Professionals

Objectives for

Hospitals

Stage 1 Measures

Improving quality,

safety, efficiency,

and reducinghealth disparities.

Provide access to

comprehensive

patient health datafor patient’s health

care team.

Use computerized

physician order entry

(CPOE).

Use of CPOE for

orders

(any type) directlyentered by

authorizing

Provider.

For EPs, CPOE is used for at least 80%

of all orders.

For eligible hospitals, CPOE is used for10% of all orders.

Use evidence-

based order sets

and CPOE.

Implement drug-drug,

drug-allergy, drug-

formulary checks.

Implement drug-drug,

drug-allergy, drug-

formulary checks.

The EP/eligible hospital has enabled

this functionality.

Apply clinical

decision support at

the point of care.Generate lists of

patients who need

care and use them

to reach out to

patients.

Maintain an up-to-

date

problem list of currentand active diagnoses

based on ICD –9 –CM

or SNOMED CTR.

Maintain an up-to-

date

problem list of currentand active diagnoses

based on ICD –9 –CM

or SNOMED CTR.

At least 80% of all unique patients

seen by the EP or admitted to the

eligible hospital have at least oneentry or an indication of none

recorded as structured data.

Report information

for quality

improvement and

public reporting.

Generate and

transmit permissible

prescriptions

electronically (eRx).

At least 75% of all permissible

prescriptions written by the EP are

transmitted electronically using

certified EHR technology.

Maintain activemedication list.

Maintain activemedication list.

At least 80% of all unique patientsseen by the EP or admitted to the

eligible hospital have at least one

entry (or an indication of ‘‘none’’ if

the patient is not currently prescribed

any medication) recorded as

structured data.



Maintain active

medication allergy list.

Maintain active

medication allergy list.


seen, by the EP or admitted to the

eligible hospital have at least one

entry or (an indication of ‘‘none’’ if

the patient has no medicationallergies) recorded as structured data.

Record demographics:

- Preferred

language

- Insurance type

- Gender

- Race

- Ethnicity

- Date of birth

Record demographics:

- Preferred

language

- Insurance type

- Gender

- Race

- Ethnicity

- Date of birth

- Date & cause of

death in the event

of mortality


seen by the EP or admitted to the

eligible hospital have demographics

recorded as structured data.

Record and chart

changes in vital signs:

- Height

- Weight

- blood pressure

- Calculate and

display BMI.- Plot and display

growth charts for

children

2 –20 years, including

BMI.

Record and chart

changes in vital signs:

- Height

- Weight

- blood pressure

- Calculate and

display BMI.- Plot and display

growth charts for

children

2 –20 years, including

BMI.

For at least 80% of all unique patients

age 2 and over seen by the EP or

admitted to eligible hospital, record

blood pressure and BMI; additionally

plot growth chart for children age 2 –

20.

Record smoking status

for patients 13 years

Record smoking status

for patients 13 years

At least 80% of all unique patients 13

years old or older seen by the EP or



old or older. old or older. admitted to the eligible hospital have

‘‘smoking status’’ recorded.

Incorporate clinical

lab test results intoHER as structured

data.

Incorporate clinical

lab test results intoHER as structured

data.

At least 50% of all clinical lab tests

ordered whose results are in apositive/ negative or numerical

format are incorporated in certified

HER technology as structured data.

Generate lists of

patients by specific

conditions to use for

quality improvement,

reduction of

disparities, and

outreach.

Generate lists of

patients by specific

conditions to use for

quality improvement,

reduction of

disparities, and

outreach.

Generate at least one report listing

patients of the EP or eligible hospital

with a specific condition.

Report ambulatory

quality measures to

CMS or the States.

Report hospital

quality measures to

CMS or the States.

For 2011, provide aggregate

numerator

and denominator through attestation

as discussed in section

II(A)(3) of this proposed rule.

For 2012, electronically submit the

measures as discussed in section

II(A)(3) of this proposed rule.

Send reminders topatients per patient

preference for

preventive/ follow up

care.

Reminder sent to at least 50% of allunique patients seen by the EP that

are age 50 or over.

Implement 5 clinical

decision support rules

relevant to specialty

Implement 5 clinical

decision support rules

related to a high

Implement 5 clinical decision support

rules relevant to the clinical quality

metrics the EP/Eligible Hospital is



or high clinical

priority, including

diagnostic test

ordering, along with

the ability to trackcompliance with those

rules.

priority hospital

condition, including

diagnostic test

ordering, along with

the ability to trackcompliance with those

rules.

responsible for as described further

in section II(A)(3).

Check insurance

eligibility

electronically from

public and private

payers.

Check insurance

eligibility

electronically from

public and private

payers.

Insurance eligibility checked

electronically for at least 80% of all

unique patients seen by the EP or

admitted to the eligible hospital.

Submit claims

electronically to public

and private payers.

Submit claims

electronically to public

and private payers.

At least 80% of all claims filed

electronically by the EP or the eligible

hospital.

Engage patients

and families in

their health care.

Provide patients

and families with

timely access to

data, knowledge,

and tools to make

informed decisions

and to manage

their health.

Provide patients with

an electronic copy of

their health

information (including

diagnostic test results,

problem list,

medication lists,

allergies), upon

request.



their health


diagnostic test results,

problem list,

medication lists,

allergies, discharge

summary,procedures), upon

request.

At least 80% of all patients who

request an electronic copy of their

health information are provided it

within 48 hours.



their discharge

instructions and

procedures at time of

At least 80% of all patients who are

discharged from an eligible hospital

and who request an electronic copy of

their discharge instructions and

procedures are provided it.



discharge, upon

request.


timely electronic

access to their health


lab results, problem

list, medication lists,

and allergies) within

96 hours of the

information being

available.


seen by the EP are provided timely

electronic access to their health

information.

Provide clinical

summaries forpatients for each

office visit.

Clinical summaries are provided for at

least 80% of all office visits.

Improve care

coordination.

Exchange

meaningful clinical

information among

professional health

care team.

Capability to exchange

key clinical

information (for

example, problem list,

medication list,

allergies, diagnostic

test results), among

providers of care and

patient authorized

entities electronically.

Capability to exchange

key clinical

information (for

example, discharge

summary, procedures,

problem list,

medication list,

allergies, diagnostic

test results), among

providers of care and

patient authorized

entities electronically.

Performed at least one test of

certified EHR technology’s capacity to

electronically exchange key clinical

information.

Perform medication

reconciliation at

relevant encounters

Perform medication

reconciliation at

relevant encounters

Perform medication reconciliation for

at least 80% of relevant encounters

and transitions of care.



and each transition of

care.

and each transition of

care.

Provide summary care

record for each

transition of care and

referral.

Provide summary care

record for each

transition of care and

referral.

Provide summary of care record for at

least 80% of transitions of care and

referrals.

Improve

population and

public health.

Communicate with

public health

agencies.

Capability to submit

electronic data to

immunization

registries and actual

submission where

required and

accepted.

Capability to submit

electronic data to

immunization

registries and actual

submission where

required and

accepted.

Performed at least one test of

certified HER technology’s capacity to

submit electronic data to

immunization registries.

Capability to provideelectronic submission

of reportable lab

results (as required by

state or local law) to

public health agencies

and actual submission

where it can be

received.

Performed at least one test of theEHR system’s capacity to provide

electronic submission of reportable

lab results to public health agencies

(unless none of the public health

agencies to which eligible hospital

submits such information have the

capacity to receive the information

electronically).

Capability to provideelectronic syndromic

surveillance data to


and actual

transmission

according to

applicable law and

practice.

Capability to provideelectronic syndromic

surveillance data to


and actual

transmission

according to

applicable law and

practice.

Performed at least one test of certified EHR technology’s capacity to

provide electronic syndromic

surveillance data to public health

agencies (unless none of the public

health agencies to which an EP or

eligible hospital submits such

information have the capacity to

receive the information



electronically).

Ensure adequate

privacy and

security

protections for

personal health

information.

Ensure privacy and

security protections

for confidential

information

through operating

policies,

procedures, and

technologies and

compliance with

applicable law.

Protect electronic

health information

created or maintained

by the certified HER

technology through

the implementation of

appropriate technical

capabilities.

Protect electronic

health information

created or maintained

by the certified HER

technology through

the implementation of

appropriate technical

capabilities.

Conduct or review a security risk

analysis per 45 CFR 164.308(a)(1) and

implement security updates as

necessary.

EHR Objectives

Documents

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